Friday, May 16, 2014

Bullying Can Lead to Positive Effects

Within all previous blogs, I have talked about the negative effects of bullying. Interestingly, I have not spent much time talking about the positive effects of bullying or of the benefits bullies gain from bullying others. Below you will find a news article which reveals that bullying might actually lead bullies to lead healthier lives. Without a doubt the brain is a unique and interesting organ, could it be that human nature actually benefits from causing harm to others. Although it might be the case, as the article points out, it is not an excuse for allowing bullying to occur.

 

Study Finds Health Benefits of Bullying

Bullying is a national problem and one that some of our nation's kids have unfortunately learned about the hard way. We've long heard that the emotional effects of bullying can last with kids long after, but a new study suggests it may also affect health in a surprising way.

This new study is so fascinating because it shows health problems can show up in those bullied long after the incident, but interestingly enough, the new study also shows that bullying may make the bully healthier.

The study was just published in the journal Proceedings of the National Academy of Sciences.

Researchers found that those who bullied saw a health boost that lasted long into adulthood.

People who were bullies showed lower levels of something called c-reactive protein, which is a marker for inflammation and could mean a reduced risk of cancer and heart disease.

The researchers say this shows the powerful role that social status and bullying can have in the health of a child and they say the results suggest that their role in bullying can either become a risk or protective health factor.

Of course, no one's advocating that children start bullying to reap these health benefits later but the researchers say it is certainly an interesting connection.

Viral Video of Bullied Girl

Here's a video that has gone recently viral.  The video showcases a possible case of normalization. The little girl accuses not only a boy of bullying her within her school bus, but also of bullying conducted by the driver of the school bus. Although the girl seems to have tried to obtain help, as she states within the video, she has been mostly ignored. Since this video has gone viral, most likely this case will be addressed, but what about the other cases which receive no attention?


Bullying Principle

Below is an article from "news-press.com" written by Ashley A. Smith. This article highlights why it is important to investigate all aspects of bullying. One would never think a principle would be capable of bullying, since they are usually the individuals who are expected to set the example other people should follow. However, as stated within previous blogs, bullying seems to convey a power struggle. This article shows a possible case of a principle abusing his power in order to maintain it.

Fort Myers High principal accused of bullying by: Ashley A. Smith

Lee County school officials are investigating bullying and misconduct claims against Fort Myers High Principal Dave LaRosa.
The accusations emerged in an email this month by a sender named "Daniel Ryan". That email accused LaRosa of bullying teachers and students.
LaRosa was unavailable for comment, however, Amity Chandler, Lee's communications director sent this email response: "Like many in leadership, school principals will have supervised thousands of individuals over the course of their careers. It is inevitable that some may become dissatisfied with leadership. Unfortunately when an investigation is opened it is human nature for people to jump to conclusions.
"In every case however, the presence of an open investigation is a process that should not be construed as an immediate implication of guilt or innocence, but rather a reflection of our commitment to our students and families."
Carol Camp, who worked as an English teacher at Fort Myers High for 35 years, said she was bullied by LaRosa and resigned after seven years under his administration. Camp wasn't the writer of the email, but she was made aware of it by other teachers.
Camp said she launched a formal complaint in 2012.
"I had been there for 35 years, and I was truly under the impression that this really couldn't be happening. There must have been some mistake," she said.
Camp says LaRosa accused her of not being a good teacher. She was also moved to different classrooms, not given office space and some of her belongings were thrown away while she was on leave in Washington, D.C., taking care of her daughter.
"I was treated like a pariah," she said. "No one would speak to me."
Camp officially resigned in March.
She said other teachers have been treated in similar ways but are afraid of losing their jobs. Camp said she was approached by a group of them to go public with her story.
"I don't wish him any ill will, but I would like to see what I have gone through and what other teachers have gone through not happen again," Camp said. "We as teachers receive yearly in-service on bullying ... this year I wondered if my principal read that as well."
The News-Press attempted to seek a reply from the sender of the anonymous email, but the sender's account has been closed.

 http://www.news-press.com/story/news/education/2014/05/16/fort-myers-high-principal-accused-bullying/9155621/
 Below is a chart provided by "stopbullying.gov". This chart contains steps people can take if they notice or think they notice acts of bullying. Perhaps this chart should be posted in all schools and in the workplace. If charts similar to these were found in schools and the workplace, perhaps there would be less bullying or at least the effects of bullying would be diminished since victims and/or bystanders would know the proper steps they should take.

 Get Help Now

When you, your child, or someone close to you is being bullied, there are many steps to take to help resolve the situation. Make sure you understand what bullying is and what it is not, the warning signs of bullying, and steps to take for preventing and responding to bullying, including how to talk to children about bullying, prevention in schools and communities, and how to support children involved.
After reviewing that information, if you feel you have done everything you can to resolve the situation and nothing has worked, or someone is in immediate danger, there are ways to get help.
The problemWhat you can do
There has been a crime or someone is at immediate risk of harm.Call 911.
Someone is feeling hopeless, helpless, thinking of suicide.Contact the National Suicide Prevention Lifeline Site exit disclaimer online or at 1-800-273-TALK (8255).
The toll-free call goes to the nearest crisis center in our national network. These centers provide 24-hour crisis counseling and mental health referrals.
Someone is acting differently than normal, such as always seeming sad or anxious, struggling to complete tasks, or not being able care for themselves.Find a local counselor or other mental health services
A child is being bullied in school.
Contact the:
  1. Teacher
  2. School counselor
  3. School principal
  4. School superintendent
  5. State Department of Education
See more on working with the school.
The school is not adequately addressing harassment based on race, color, national origin, sex, disability, or religion.Contact:

Bullied News Anchor Video

Here's a video which highlights the fact that bullying not only occurs among children, but also among adults. This video also breaks other stereotypes, including that bullying occurs within schools. This video shows how bullying can occur within the workplace. In addition, this video reveals how cyber bullying can be conducted. Fortunately, this video also has a positive note. Note how the news anchor speaks of anonymous people standing up for her. Without a doubt this is an aspect society needs to work on: transforming bystanders into defenders. 


Listverse List on Bullying

Here is an interesting list regarding the depressing facts of bullying. This list was written by Morris M. from Listverse.com Although the author does not provide factual evidence to back-up his statements, this list is a great thought generator, which really gets you thinking about the various different depressing facts and consequences of bullying.

10 Deeply Depressing Facts About Bullying

Morris M.
Who here was bullied at school? If you’re from the US, chances are you experienced it at some point: Around 80 percent of all American school kids report being harassed by their peers. But modern bullying goes way beyond Nelson Muntz handing out wedgies and into some seriously dark, disturbing territory.

10It Destroys Your Future Job Prospects

01
The standard old-school view says bullying is a “natural part of growing up,” something we leave behind when we graduate to the world of work. But research suggests not only is this untrue, but being bullied can ensure we never even get to work at all.
In 2013, a group of researchers decided to check in on some young adults they’d included in a bullying study a decade and a half ago. Now in their mid-twenties, the group had grown up and seemingly moved on. But when the study doctors dug a little deeper, they found some shocking results. The subjects who had been bullied way back in middle school were nearly two times less likely to hold down a job than their non-bullied peers.
Unsurprisingly, this had a knock-on effect on the victims’ finances. Subjects who had been bullied were far more likely to live in poverty and make bad financial decisions. As the misery-flavored icing on this depressing cake, they also tended to suffer from health problems, leading to skyrocketing health bills.

9It Damages Your Mental Health

02
How many of you can still remember the absolute worst moments of your childhood? That time when you wet yourself when you were way too old to get away with it or got completely humiliated by some arrogant teacher? Now imagine feeling that about your entire childhood. It’d destroy you, right?
If recent research is anything to go by, the answer is a resounding “yes.” As another part of the above study, researchers looked into the long-term mental health effects of childhood bullying. Adults who were bullied at school suffered crippling levels of anxiety and agoraphobia, while also being prone to severe panic attacks. Meanwhile, those who had responded to being bullied by becoming bullies themselves were prone to awful depressions and feelings of panic. In short, cruelty that had happened up to 15 years beforehand was still wreaking havoc on its victims’ lives.

8It Can Get You In Trouble With The Law

03
It’s no secret that bullying sometimes gets so out of hand that the cops are called in. But although we might expect bullies to experience the odd run-in with the law, their victims surprisingly often experience the very same thing.
According to multiple studies, being long-term bullied as a kid increases your chances of being arrested. Not by some tiny amount—one study estimated that nearly a quarter of all kids who get picked on will wind up in a cell at some point.
The trouble is that late childhood and early adolescence are the times when we’re meant to learn social skills and how to be a part of society. If we spend all that time being beat on and made to feel like dirt, joining society no longer seems a desirable achievement. Long-term bullied kids shut off. They disconnect from the world around them and become miserable, angry, and bitter. All that anger and bitterness tends to come out when they hit adulthood, resulting in fights, petty crime, and jail time.

7It Affects The Entire Economy

04
But it’s not just those who were bullied who have to live with the effects. According to recent research, it affects all of us, whether or not we were even involved. Youth violence costs the US economy $158 billion every year.
This budget-shredding figure comes courtesy of Plan International, a charity devoted to children’s rights. They reached it by calculating public money lost by frightened kids skipping school and future earnings lost to those who drop out to escape their tormenters. They also agree that it’s only an estimate: The real figure is likely to be much higher. If true, this would mean the United States loses almost double the federal education budget annually to bullying.

6It Increases Sexual Violence

05
Most of us would consider childhood bullying and teenage sexual violence to be completely different things. But a joint study between the Center for Disease Control and Illinois University says otherwise. According to their research, there’s plenty of evidence for a “bully–sexual violence pathway.”
“Sexual violence” was taken to include acts like pulling down clothes, as well as groping or grabbing genitals. And, happily, only a small minority of children seemed to graduate from bullying to any of these things. But the researchers also noted that the problems get worse as the kids get older, culminating in some pretty dark stuff. Bullies sometimes transplant their sexual urges onto their victims, while other boys get so freaked out at the idea of being gay that they sexually harass girls to prove their heterosexuality.

5It Makes You Prone To Suicide

06
Studies have claimed adolescents who get picked on are around 2.5 times more likely to try to kill themselves. But what’s less well known is how that risk stays with you for life. In 2007, a UK study found that adults who had been bullied at school were twice as likely to attempt suicide in later life.
The study included over 7,000 people all the way from young adulthood right up to the elderly. It specifically controlled for other factors like childhood sexual abuse, violent parents, and having been a teenage runaway. Yet the authors still concluded that bullying alone could cause a significant rise in your adult suicide risk. In essence, bullying stays with you. And what seems like a harmless bit of schoolyard fun could in reality be a long-term death sentence.

4It Messes Up Everyone Involved

07
So far, we’ve focused mostly on the baggage victims get stuck with in later life, but bullies themselves can suffer as well.
On just about every single measurement that matters, bullies do as bad as or worse than their victims. They’re more likely to engage in risky behavior, experience negative financial outcomes, and suffer social problems as adults. The only measurement where they do better than their victims is health, and even then, they do worse than those who weren’t involved in bullying at all.
So what’s going on? Is this just a symptom of the classic tortured bully trope, where a kid lashes out because of inner pain? Well, maybe in some cases. But studies have shown that plenty of normal, well-adjusted, and popular kids become bullies, too. Unbelievably, it may be that the simple act of bullying messes up the perpetrator as much as it does the victim.

3We Can’t Solve It

08
By now, you might be feeling slightly depressed. At least there’s a ray of light, though. Just pump enough money into anti-bullying campaigns, and it’ll all be sorted, right? Well, sorry to bring you down even more, but Arlington University says otherwise.
In a study published in the Journal of Criminology, researchers examined over 7,000 kids at 195 different schools, with and without anti-bullying programs. Schools with bullying prevention procedures suffered higher rates of bullying than those without. According to the study’s authors, things like “anti-bullying week” not only awaken kids to the concept of picking on others, they unintentionally give them information on how to weasel out of punishment afterwards.
Things aren’t totally hopeless. The researchers suggest more sophisticated programs could help identify bully-victim dynamics and create tailor-made prevention policies. But unless a lot of people are willing to pump a lot of money into them, these projects likely won’t ever get off the ground.

2Kids Actively Reward It

09
If we adults are powerless to help bullied kids, then it’s tempting to think maybe the kids themselves can make a difference. Only don’t hold your breath: A recent UCLA study revealed that middle school kids get more popular the more they bully.
This creates a massive problem for campaigners. If kids associate being a bully with being the coolest kid in class and standing up to bullying with getting beaten for your lunch money, then they’re going to side with the bullies every time. In fact, only the top 2 percent of universally liked kids in any given grade and the bottom 2 percent of universally despised kids seem immune from the need to bully, according to the study. For everyone else, acting like a total jerk is a guaranteed way up the social ladder.

1It’s Human Nature

10
Every single society in human history has had bullies, in one form or another. If you want something to blame, look no further than evolution.
Bullying exists across the animal kingdom, and in primates, it serves a very specific function. Chimps or apes who fail to conform to a group dynamic can endanger everyone around them or at least make the group less effective at surviving. So a bit of bullying can keep wayward primates in line.
Humans no longer need strict conformity and total cooperation to survive, yet our urge to pick on others remains. The whole thing is nothing more than a throwback, a septic appendix poisoning the entire body of humanity. And we’re stuck with it.

Follow this link to view the original list on its website listverse.com:
http://listverse.com/2014/03/30/10-deeply-depressing-facts-about-bullying/

Wednesday, May 7, 2014

Video 4

Group 5 discusses the struggles of our papers and the course as a whole.

Tuesday, May 6, 2014

Thursday, April 24, 2014

Rate of Diagnosis for Autism Grows

The New York Times

The rate at which doctors diagnosed autism and related disorders in 8-year-olds increased between 2008 and 2010 in some parts of the country, a report released by the federal Centers for Disease Control and Preventionon Thursday said. The average rate was one in 68 children, up from one in 88 in 2008. The report — based not on direct diagnoses but on a review of records — was not nationally representative and drew on data gathered three years before a significant tightening in the clinical definition of autism. The likelihood of receiving a diagnosis of autism has increased sharply over the past three decades, and no one knows why, or whether the 2010 numbers are currently meaningful.

Inside the Mind of a Child With Autism


New York Times
Therapists who specialize in autism often use a child’s own interests, toys or obsessions as a way to connect, and sometimes to reward effort and progress on social skills. The more eye contact a child makes, for example, the more play time he or she gets with those precious maps or stuffed animals.
But now a group of scientists and the author of a new book are suggesting that those favorite activities could be harnessed in a deeper, more organic way. If a child is fascinated with animated characters like Thomas the Tank Engine, why not use those characters to prompt and reinforce social development?
Millions of parents do this routinely, if not systematically, flopping down on the floor with a socially distant child to playact the characters themselves.
“We individualize therapy to each child already, so if the child has an affinity for certain animated characters, it’s absolutely worth studying a therapy that incorporates those characters meaningfully,” said Kevin Pelphrey, director of the child neuroscience laboratory at Yale.
He and several other researchers, including John D. E. Gabrieli of M.I.T., Simon Baron-Cohen of the University of Cambridge andPamela Ventola of Yale, are proposing a study to test the approach.
The idea came from Ron Suskind, a former Wall Street Journal reporter whose new book “Life, Animated” describes his family’s experience reaching their autistic son, Owen, through his fascination with Disney movies like “The Little Mermaid” and “Beauty and the Beast.” It was Mr. Suskind’s story that first referred to ‘“affinity therapy.” He approached the researchers to put together a clinical trial based on the idea that some children can develop social and emotional instincts through the characters they love.
Experts familiar with his story say the theory behind the therapy is plausible, given what’s known from years of studying the effects of other approaches.
“The hypothesis they have put forward is sound, and absolutely worth studying,” said Sally J. Rogers, a professor of psychiatry at the MIND Institute of the University of California, Davis. “If you think about these animated characters, they’re strong visual stimuli; the emotions of the characters are exaggerated, those eyebrows and the big eyes, the music accompanying the expressions. Watching those characters is the way many of us learned scripts that are appropriate in social situations.”
But Dr. Rogers cautioned that using animated characters is hardly the key to reaching all autistic children. Many are fascinated by objects or topics without inherent social content — maps, for instance. But for those who fixate on movies, television shows or animated characters, affinity therapy makes sense, she said.
The researchers brought together by Mr. Suskind have written a proposal for a study of the approach. It calls for a 16-week trial for 68 children with autism, ages 4 to 6. Half the children would receive affinity therapy, using the shows or movies they love as a framework to enhance social interaction, building crucial abilities like making eye contact and joint play.
The other half, the control group, would engage in the same amount of interaction with a therapist but in free play, led by the child’s interest. Therapists have had some success using the latter approach, most notably in a therapy called Floortime, developed by Dr. Stanley Greenspan.
In autism therapy, progress is measured in increments and tends to be slow, especially in severely affected children, experts say. But the disorder — the autism spectrum, as it’s known — includes a very diverse group of children whose prospects for improvement are unpredictable and individual. Some children develop social skills relatively quickly, while others are stubbornly unreachable.
Dr. Pelphrey said that the affinity approach would incorporate many elements of pivotal response treatment, a type of therapy being intensely studied. It incorporates a system of rewards into normal interactions between a therapist (or parent) and the child, playing together.
Sarah Calzone of Stratford, Conn., said her son, now 7 years old, became more socially adept in a pivotal response trial at Yale. “The way it works is that, for instance, one time the therapist was playing with my son, blowing bubbles,” Ms. Calzone said. “Then the therapist stopped and looked away. Of course my son still wanted to see the bubbles, so he had to stop, too, and look in the same direction, then make eye contact and ask to continue.”
Those two responses, making eye contact and so-called perspective taking, recognizing another person’s point of view, developed quickly in the therapy. Her son, who has engaged in various therapies nearly every day for most of his life, is now in regular classes at school.
Dr. Pelphrey said that affinity therapy would deploy some of the same techniques, with the therapist playacting a favorite character and inhabiting the scenes with the child.
“Instead of watching Thomas the Tank Engine as a reward, for instance, we would have the child enter the social setting, with Thomas and Percy and the other characters,” and learn through them about eye contact, joint play and friendship, he said. The scientists plan to submit their study proposal to the National Institute of Mental Health for funding.
“The whole thing has been exciting, and a little weird,” said Mr. Suskind, now a senior fellow at Harvard, “having these leading neuroscientists listen to me and say, ‘O.K., what can we do to help?’ ”


Diagnosis in Autism: A Survey of Over 1200 Patients in the UK

The results of a survey of almost I300 parent members of autistic societies in the UK are described. The ages of their children ranged from 2 to 49 years. The survey focused on parents' views of the diagnostic process and data were collected on the age at which diagnosis was made, the time taken to obtain a diagnosis and the professionals involved. Differences in geographical area were also assessed. Overall, the results indicate that children are now being diagnosed earlier than in previous decades, but the average age of diagnosis is still around 6 years. There are also wide regional variations in diagnosis. The survey indicates that many parents continue to experience lengthy and often frustrating delays before they finally receive a diagnosis. Moreover, even when this process is completed, the amount of practical help subsequently provided is generally very limited. Factors related to parental satisfaction with the diagnostic process are discussed in detail.



Reference

doi: 10.1177/1362361397012003

Tuesday, April 22, 2014


According to the CDC


The rate of autism has steadily increased, according to the CDC. The CDC estimates that approximately 2% or more of children from birth to 21 years of age have Autism Spectrum Disorder (ASD) in New Jersey.
Autism is a complex condition. No single factor can explain why more children are being identified with ASD, although a combination of genetic and environmental factors play a role. In addition, some of the increase in the rates in the CDC's study may be due to: changes in the diagnosis and treatment, greater awareness, and better record keeping.

Previous CDC Autism Prevalence Study Results

A Decade of Data

With the report released in March 2014, we now have a decade of surveillance data utilizing consistent methodology that presents a clear picture of the trends since 2000. Here are the numbers:

1 in 68 (US); 1 in 45 (NJ)
Report Year: 2014
Surveillance Year:  2010

CDC’s ADDM Network reported that about 1 in 68 children had an ASD (based on children who were 8 years old in 2010). Data from 11 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 21.9 per 1,000 or 1 in 45.  See 2014 Report.

1 in 88 (US); 1 in 49 (NJ)
Report Year: 2012
Surveillance Year:  2008

CDC’s ADDM Network reported that about 1 in 88 children had an ASD (based on children who were 8 years old in 2008). Data from 14 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 20.5 per 1,000 or 1 in 49.  See 2012 Report.

1 in 110 (US)
Report Year: 2009Surveillance Year:  2006 

CDC’s ADDM Network reported that about 1 in 110 children had an ASD (based on children who were 8 years old in 2006).
Data from 11 AADM Network Sites were reviewed.  New Jersey was not included in this report.  See 2009 Report.

1 in 150 (US); 1 in 94 (NJ)
Report Year: 2007Surveillance Year:  2002

CDC’s ADDM Network reported that about 1 in 150 children had an ASD (based on children who were 8 years old in 2002).
Data from 14 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 10.6 per 1,000 or 1 in 94. This report combined results from 2002 with those from 2000.  See 2007 Report.

1 in 166 (US); 1 in 101 (NJ)
Report Year: 2007Surveillance Year:  2000

CDC’s ADDM Network first reported that about 1 in 166 children had an ASD (based on children who were 8 years old in 2000).
Data from 6 AADM Network Sites were reviewed, including New Jersey.  New Jersey's rate was approx. 9.9 per 1,000 or 1 in 101.  This report combined results from 2000 with the data from 2002.  See 2007 Report.

Other Prevalence Studies/Surveys

National Survey of Children's Health -- 1 in 50 (US)

Report Date:  March 20, 2013
Survey Period:  2011 to 2012
Report:  http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf
Statistics as reported by parents of school-aged children (ages 6–17 years) in 2011–2012.  Data were drawn from the 2007 and 2011–2012 National Survey of Children’s Health (NSCH), which are independent nationally representative telephone surveys of households with children. The surveys were conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics with funding and direction from the Health Resources and Services Administration’s Maternal and Child Health Bureau.  Prior report of data from 2007 survey indicated a rate of 1 in 86 children (ages 6-17).

http://www.autismnj.org/prevalence-rates 

Center for Disease Control on Autism in NJ


Article from March 27, 2014:
The Centers for Disease Control (CDC) released a report showing 1 in 68 children nationally has an Autism Spectrum Disorder.  This newest estimate is based on the CDC's evaluation of health and educational records of all 8-year-old children in 2010 in 11 states, including New Jersey.  New Jersey has the highest rates, with 1 in 45, 1 in 28 boys. The national rate marks an increase of 30% from the previous 1 in 88 statistic.  
The Centers for Disease Control (CDC) released a report today showing 1 in 68 children nationally has an autism spectrum disorder.  This newest estimate is based on the CDC's evaluation of health and educational records of 8-year-old children in 2010 in 11 states, including New Jersey.  New Jersey has the highest rates, with 1 in 45, 1 in 28 boys. The national rate marks an increase of 30% from the previous 1 in 88 statistic.  
  • Gender:  The report shows that autism prevalence remains 5 times more likely in boys than girls, with 1 in 42 boys and 1 in 189 girls (nationally) identified with an ASD in this latest report.
  • Age of Diagnosis:  The average age of diagnosis is still 4 years of age, although autism can be reliably established as early as 18 months.
  • IQ:  One notable change is that more children identified with an ASD have average or above average intelligence, from one-third in 2002 to half in 2010.
  • Methodology:  With this report, we now have a decade of surveillance data utilizing consistent methodology that presents a clear picture of the trends since 2000.   It should be noted that all studies utilized DSM-IV diagnostic criteria.  

Tuesday, April 15, 2014

Sensory Integration for Autism


Sensory Integration

By Cindy Hatch-Rasmussen, M.A., OTR/L

Children and adults with autism, as well as those with other developmental disabilities, may have a dysfunctional sensory system. Sometimes one or more senses are either over- or under-reactive to stimulation. Such sensory problems may be the underlying reason for such behaviors as rocking, spinning, and hand-flapping. Although the receptors for the senses are located in the peripheral nervous system (which includes everything but the brain and spinal cord), it is believed that the problem stems from neurological dysfunction in the central nervous system--the brain. As described by individuals with autism, sensory integration techniques, such as pressure-touch can facilitate attention and awareness, and reduce overall arousal. Temple Grandin, in her descriptive book, Emergence: Labeled Autistic, relates the distress and relief of her sensory experiences.

Sensory integration is an innate neurobiological process and refers to the integration and interpretation of sensory stimulation from the environment by the brain. In contrast, sensory integrative dysfunction is a disorder in which sensory input is not integrated or organized appropriately in the brain and may produce varying degrees of problems in development, information processing, and behavior. A general theory of sensory integration and treatment has been developed by Dr. A. Jean Ayres from studies in the neurosciences and those pertaining to physical development and neuromuscular function. This theory is presented in this paper.

Sensory integration focuses primarily on three basic senses--tactile, vestibular, and proprioceptive. Their interconnections start forming before birth and continue to develop as the person matures and interacts with his/her environment. The three senses are not only interconnected but are also connected with other systems in the brain. Although these three sensory systems are less familiar than vision and audition, they are critical to our basic survival. The inter-relationship among these three senses is complex. Basically, they allow us to experience, interpret, and respond to different stimuli in our environment. The three sensory systems will be discussed below.

Tactile System: The tactile system includes nerves under the skin's surface that send information to the brain. This information includes light touch, pain, temperature, and pressure. These play an important role in perceiving the environment as well as protective reactions for survival.

Dysfunction in the tactile system can be seen in withdrawing when being touched, refusing to eat certain 'textured' foods and/or to wear certain types of clothing, complaining about having one's hair or face washed, avoiding getting one's hands dirty (i.e., glue, sand, mud, finger-paint), and using one's finger tips rather than whole hands to manipulate objects. A dysfunctional tactile system may lead to a misperception of touch and/or pain (hyper- or hyposensitive) and may lead to self-imposed isolation, general irritability, distractibility, and hyperactivity.

Tactile defensiveness is a condition in which an individual is extremely sensitive to light touch. Theoretically, when the tactile system is immature and working improperly, abnormal neural signals are sent to the cortex in the brain which can interfere with other brain processes. This, in turn, causes the brain to be overly stimulated and may lead to excessive brain activity, which can neither be turned off nor organized. This type of over-stimulation in the brain can make it difficult for an individual to organize one's behavior and concentrate and may lead to a negative emotional response to touch sensations.

Vestibular System: The vestibular system refers to structures within the inner ear (the semi-circular canals) that detect movement and changes in the position of the head. For example, the vestibular system tells you when your head is upright or tilted (even with your eyes closed). Dysfunction within this system may manifest itself in two different ways. Some children may be hypersensitive to vestibular stimulation and have fearful reactions to ordinary movement activities (e.g., swings, slides, ramps, inclines). They may also have trouble learning to climb or descend stairs or hills; and they may be apprehensive walking or crawling on uneven or unstable surfaces. As a result, they seem fearful in space. In general, these children appear clumsy. On the other extreme, the child may actively seek very intense sensory experiences such as excessive body whirling, jumping, and/or spinning. This type of child demonstrates signs of a hypo-reactive vestibular system; that is, they are trying continuously to sti mulate their vestibular systems.

Proprioceptive System: The proprioceptive system refers to components of muscles, joints, and tendons that provide a person with a subconscious awareness of body position. When proprioception is functioning efficiently, an individual's body position is automatically adjusted in different situations; for example, the proprioceptive system is responsible for providing the body with the necessary signals to allow us to sit properly in a chair and to step off a curb smoothly. It also allows us to manipulate objects using fine motor movements, such as writing with a pencil, using a spoon to drink soup, and buttoning one's shirt. Some common signs of proprioceptive dysfunction are clumsiness, a tendency to fall, a lack of awareness of body position in space, odd body posturing, minimal crawling when young, difficulty manipulating small objects (buttons, snaps), eating in a sloppy manner, and resistance to new motor movement activities.

Another dimension of proprioception is praxis or motor planning. This is the ability to plan and execute different motor tasks. In order for this system to work properly, it must rely on obtaining accurate information from the sensory systems and then organizing and interpreting this information efficiently and effectively.

Implications: In general, dysfunction within these three systems manifests itself in many ways. A child may be over- or under-responsive to sensory input; activity level may be either unusually high or unusually low; a child may be in constant motion or fatigue easily. In addition, some children may fluctuate between these extremes. Gross and/or fine motor coordination problems are also common when these three systems are dysfunctional and may result in speech/language delays and in academic under-achievement. Behaviorally, the child may become impulsive, easily distractible, and show a general lack of planning. Some children may also have difficulty adjusting to new situations and may react with frustration, aggression, or withdrawal.

Evaluation and treatment of basic sensory integrative processes is performed by occupational therapists and/or physical therapists. The therapist's general goals are: (1) to provide the child with sensory information which helps organize the central nervous system, (2) to assist the child in inhibiting and/or modulating sensory information, and (3) to assist the child in processing a more organized response to sensory stimuli.